Provider Demographics
NPI:1275930521
Name:BEHAVIORAL EDUCATION AND TREATMENT, INC.
Entity Type:Organization
Organization Name:BEHAVIORAL EDUCATION AND TREATMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-620-9440
Mailing Address - Street 1:721 W LAKE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2035
Mailing Address - Country:US
Mailing Address - Phone:630-620-9440
Mailing Address - Fax:630-620-9540
Practice Address - Street 1:721 W LAKE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2035
Practice Address - Country:US
Practice Address - Phone:630-620-9440
Practice Address - Fax:630-620-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-2151-0003-A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health